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Physician Compares Ablation Techniques For Barrett’s Esophagus

The first cases of Barrett esophagus (BE) ablation in the late 1980s used YAG and Argon laser. Since then, a myriad of ablation techniques have been described, including multipolar electrocautery (MPEC), argon plasma coagulation (APC), cryotherapy, radiofrequency ablation (RFA), and endoscopic mucosal resection (EMR). Each technique has had its advocates, and some of the techniques appear to have certain advantages in certain types of BE: e.g., long segment, nodular, etc.

Most cases of BE are short segment, and most neoplastic cases do not have nodules or erosions. So the question I would like to see discussed is: In a patient with 1–2 cm of otherwise featureless flat but neoplastic BE:

What ablation technique would you use, and what do you feel makes this technique advantageous? Read more »

*This blog post was originally published at Gut Check on Gastroenterology*

Muscle Strain: Should You Treat It With Hot Packs Or Cold Packs?

Applying an ice pack to a muscle strain.Along with blisters and sprains, muscle strains are among the most common afflictions for active persons in the outdoors. Common medical dogma is to use the “RICE”  approach for sprains and strains of—rest, ice (application of cold), compression, and elevation.

This is more applicable to sprains (e.g., an ankle sprain) than to strains, because the sprained body part is usually a limb (ankle, knee, wrist)
that is amenable to this approach. Strains more often involve larger muscle
groups, such as those in the back, chest, thigh or abdomen, or difficult-to-approach areas, such as the neck or groin.

Prevailing theory for treatment of a muscle strain is that one applies external cold for 24 to 48 hours, and discontinues it after 72 hours, at which time one begins application of external heat. The rationale is
that swelling (from leakage of blood and tissue fluid) and inflammation prevail in the first two days, and that after three days, one wishes to increase local circulation and augment reabsorption of the fluid that has collected. There is some science to this, and these recommendations have been around for as long as I can recall. Read more »

This post, Muscle Strain: Should You Treat It With Hot Packs Or Cold Packs?, was originally published on Healthine.com by Paul Auerbach, M.D..

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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